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Additional Insured — Owners, Lessees or Contractors — AB 90 67 12 93 <br />Policy Amendment Section II <br />Insured: Serrano Animal & Bird Hospital Policy Number AZC80841431 <br />RENEWAL OF AZC80841431 <br />Producer Veterinary Ins Services Co Effective Date 07/01/09 & 7/10/10 <br />Schedule <br />Name of Person(s) or Organization(s) <br />City of Santa Ana, its officers, agents, employees, representatives, and volunteers <br />(If no entry appears above, information required to complete this Endorsement will be shown in the Declarations <br />as applicable to this Endorsement) <br />The following is Added to Part I — WHO IS AN IN- <br />SURED in the Business Liability Section of this policy <br />5. The person or organization shown in the Schedule <br />is also an insured, but only with respects to liability <br />arising out of your work for that insured by or for <br />you. <br />All other terms and conditions of the policy apply. <br />This form must be attached to Change Endorsement when issued after the policy is written. <br />One of the Fireman's Fund Insurance Companies as named in the policy. <br />Sa@ B..Na1Y <br />Secretary <br />z4� 74" <br />Authorized Agent <br />APPROVED AS <br />JOMPTI W. F1 <br />CITY ATTO <br />AB9067 12-93 <br />Contains copyrighted Material of Insurance Services Offices, Inc., 1984 <br />ER <br />91f c&e[E. LagZpcco <br />President <br />Date <br />6/1S/10 <br />